NHPC17

The Academy Health National Health Policy Conference is one of my two favorite conferences to attend every year. The other is my specialty society’s Leadership and Advocacy Conference. But the reason why I enjoy the NHPC – which is geared toward health services researchers and often attended by policy makers – is that it delves into the evidence supporting policy and discusses the prospects for reform. Those are two concepts that we attempt to push for on this blog.

The Cassidy-Collins Plan
The opening plenary session saw Senator Bill Cassidy – a gastroenterologist from Louisiana – describe to attendees his plan for a post-Obamacare health care system. The Cassidy-Collins plan is well described here, but briefly has 3 components as described by Sarah Kliff of Vox:
Lessons on Universal Health Care
An interesting breakout session discussed the history of universal health care attempts in Massachusetts, Vermont, and Colorado. Many people remember ‘ successful bid under Governor Mitt Romney in creating a health care system based on insurance regulation reforms, an individual mandate, and subsidies to help low-income people afford coverage. It was the Massachusetts plan that ultimately became Title I of the .
Lessons from Vermont’s attempt at universal health cares show that by providing heavy subsidies to purchase insurance, even without a mandate, insurance rates can be upward of 93%. Today, with the ACA’s help, the insurance rate is at 95%. However, some of the reasons why Vermont couldn’t make the jump from a state aggressively implementing the Affordable Care Act to a single-payer system included the decision to offer coverage to too many people (including out of state residents that worked in Vermont businesses) and the high tax rates required to fund the plan.
Similarly, Colorado’s bid to amend it’s state constitution to provide for a single-payer system lost nearly 4 to 1 largely due to the hefty taxes needed to fund such a program.
Reading the Policy Tea Leaves
Two other panel discussions, one by a group of congressional staff veterans and another among policy prognosticators, attempted to read the tea leaves into what “repeal and replace” might look like. While there was a great discussion into the many Republican policy elements circulating on Capitol Hill (block grants for Medicaid, health savings accounts, repealing the individual mandate, and cutting down on essential health benefits) ultimately the conclusions can be summed up in one tweet.